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Sanekommu H, Taj S, Mah Noor R, Umair Akmal M, Ramirez C, Shah P, Hossain M, Arif A. Chronic Pancreatitis-Induced Thrombosis of Celiac and Superior Mesenteric Artery. J Med Cases 2023; 14:322-326. [PMID: 37868327 PMCID: PMC10586330 DOI: 10.14740/jmc4112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/01/2023] [Indexed: 10/24/2023] Open
Abstract
Every year, nearly 60,000 hospitalizations occur in the United States due to chronic pancreatitis (CP). CP can cause severe chronic abdominal pain, pancreatic insufficiency, and increased risk of pancreatic cancer. While venous thrombotic complications are common, arterial thrombotic events are rarely reported in CP. This report describes a case of a 43-year-old female who presented with severe worsening abdominal pain due to CP. Diagnostic imaging disclosed thrombosis of superior mesenteric artery (SMA) and celiac artery (CA) with acute bowel wall changes reflecting ischemic changes, resulting in acute-on-chronic mesenteric ischemia. Endovascular stent placement relieved the ischemia with the resolution of pain. Arterial thrombosis should be considered as a diagnostic possibility when patients with CP present with a significant change in symptoms. Importantly, the case demonstrates that endovascular treatment with stent placement can relieve ischemia and resolve symptoms in patients with CP.
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Affiliation(s)
| | - Sobaan Taj
- Department of Medicine, Jersey Shore University Medical Center, Neptune City, NJ 07753, USA
| | - Rida Mah Noor
- International University of Kyrgyzstan-International School of Medicine, Eastern Campus, Bishkek, Kyrgyzstan
| | | | - Claudia Ramirez
- Department of Medicine, Jersey Shore University Medical Center, Neptune City, NJ 07753, USA
| | - Pranav Shah
- Department of Radiology, Jersey Shore University Medical Center, Neptune City, NJ 07753, USA
| | - Mohammad Hossain
- Department of Medicine, Jersey Shore University Medical Center, Neptune City, NJ 07753, USA
| | - Asif Arif
- Department of Medicine, Jersey Shore University Medical Center, Neptune City, NJ 07753, USA
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Alvi AT, Santiago LE, Lopez-Medal M. Acute Pancreatitis-Induced Thrombosis of Celiac Artery: An Unusual Complication of Acute Pancreatitis. Cureus 2023; 15:e46249. [PMID: 37908938 PMCID: PMC10614078 DOI: 10.7759/cureus.46249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Acute pancreatitis can lead to both local and systemic complications, including pseudocysts, biliary obstruction, duodenal obstruction, sepsis, necrosis, vascular complications, and multiorgan failure. Vascular complications following acute pancreatitis are associated with a high risk of morbidity and mortality due to their thrombotic and hemorrhagic effects. When thrombosis is present, it usually involves the splanchnic venous system, but it is rarely seen in the arterial system. Celiac artery thrombosis is rare with only a few cases reported in the literature. In this case, we present a 65-year-old Hispanic female who presented to the emergency department with abdominal pain and nausea, with computed tomography angiography (CTA) of the abdomen revealing acute pancreatitis with thrombosis of the celiac artery, which was managed with anticoagulation.
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Affiliation(s)
- Ali Tariq Alvi
- Internal Medicine, HCA Florida Westside Hospital, Plantation, USA
- Internal Medicine, HCA Florida Northwest Hospital, Margate, USA
| | - Luis E Santiago
- Internal Medicine, HCA Florida Westside Hospital, Plantation, USA
- Internal Medicine, HCA Florida Northwest Hospital, Margate, USA
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Walia D, Saraya A, Gunjan D. Vascular complications of chronic pancreatitis and its management. World J Gastrointest Surg 2023; 15:1574-1590. [PMID: 37701688 PMCID: PMC10494584 DOI: 10.4240/wjgs.v15.i8.1574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/16/2023] [Accepted: 06/06/2023] [Indexed: 08/25/2023] Open
Abstract
Chronic pancreatitis is a chronic fibro-inflammatory disorder of the pancreas, resulting in recurrent abdominal pain, diabetes mellitus, and malnutrition. It may lead to various other complications such as pseudocyst formation, benign biliary stricture, gastric outlet obstruction; and vascular complications like venous thrombosis, variceal and pseudoaneurysmal bleed. Development of varices is usually due to chronic venous thrombosis with collateral formation and variceal bleeding can easily be tackled by endoscopic therapy. Pseudoaneurysmal bleed can be catastrophic and requires radiological interventions including digital subtraction angiography followed by endovascular obliteration, or sometimes with a percutaneous or an endoscopic ultrasound-guided approach in technically difficult situations. Procedure-related bleed is usually venous and mostly managed conservatively. Procedure-related arterial bleed, however, may require radiological interventions.
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Affiliation(s)
- Dinesh Walia
- Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Anoop Saraya
- Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Deepak Gunjan
- Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi 110029, India
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Hong JT, Joglekar S, Bradshaw L, Hassen S, Sengupta S. A right anomalous renal artery originating from the superior mesenteric artery. ANZ J Surg 2023; 93:426-427. [PMID: 35751766 DOI: 10.1111/ans.17879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/01/2022] [Accepted: 06/15/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Jason T Hong
- Department of Upper Gastrointestinal and Hepatobiliary Surgery, Box Hill Hospital, Melbourne, Victoria, Australia
| | - Shantanu Joglekar
- Department of Upper Gastrointestinal and Hepatobiliary Surgery, Box Hill Hospital, Melbourne, Victoria, Australia.,Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Luke Bradshaw
- Department of Upper Gastrointestinal and Hepatobiliary Surgery, Box Hill Hospital, Melbourne, Victoria, Australia
| | - Sayed Hassen
- Department of Upper Gastrointestinal and Hepatobiliary Surgery, Box Hill Hospital, Melbourne, Victoria, Australia.,Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Shomik Sengupta
- Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.,Department of Urology, Box Hill Hospital, Melbourne, Victoria, Australia
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Kalas MA, Leon M, Chavez LO, Canalizo E, Surani S. Vascular complications of pancreatitis. World J Clin Cases 2022; 10:7665-7673. [PMID: 36158481 PMCID: PMC9372863 DOI: 10.12998/wjcc.v10.i22.7665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/01/2022] [Accepted: 06/30/2022] [Indexed: 02/06/2023] Open
Abstract
More than 200000 hospital admissions happen per year for acute pancreatitis and more than 50000 for chronic pancreatitis in the United States of America. Necrotizing pancreatitis accounts for 20%-30% of the cases. One-quarter of the patients with pancreatitis develop vascular complications, which carries a high mortality. This mini-review will address these complications that can help primary care physicians and hospitalists in managing their patients effectively.
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Affiliation(s)
- M Ammar Kalas
- Department of Medicine, Texas Tech University Health Center, El Paso, TX 79905, United States
| | - Monica Leon
- Department of General Surgery, Centro Medico ABC, Ciudad de Mexico 01120, Mexico
| | - Luis Omar Chavez
- Department of Medicine, Texas Tech University Health Center, El Paso, TX 79905, United States
| | - Eduardo Canalizo
- Department of General Surgery, Centro Medico ABC, Ciudad de Mexico 01120, Mexico
| | - Salim Surani
- Department of Medicine, Texas A&M University, Bryan, TX 77807, United States
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